Short course of glucocorticoids in patients with protracted and chronic gout arthritis. Part I: predictors of therapy efficacy

Objective. To reveal short course of glucocorticoid (GC) therapy efficacy predictors in pts with gout arthritis. Material and methods. 59 pts with tophaceous gout (crystal-verified diagnosis) and arthritis of three and more joints lasting more than a months in spite of treatment with sufficient doses of nonsteroidal anti-inflammatory drugs were included. Median age of pts was 56 [48;63], median disease duration - 15,2 years [7,4;20], median swollen joint count at the examination — 8 [5; 11]. The patients were randomized into 2 groups. Methylprednisolone was administered in one of them, betamethasone — in the other. Results, four variants of treatment response were described: full resolution of arthritis — 24 (41%), recurrent exacerbation — 28 (48%), insufficient arthritis resolution — 2 (3%) and clinically insignificant (unresponders) — 5 (8%) pts. Pts in group with arthritis recurrence at the entry were significantly younger than pts with resolved arthritis (52 [47;60] and 59 [52;68] respectively, U-test p=0,02), had more inflamed joints (9 [7,5; 11 ] and 5 [4;9[ respectively, U-test p=0,02), longer duration of last exacerbation (52 [8;52[ and 13 [7,5;52J respectively, U-test p>0,05), higher values of pain, joint index and swelling index (U-test p